The eHealth Exchange* and CONNECT Overview *eHealth Exchange – formerly known as the Nationwide Health Information Exchange (NwHIN) Table of Contents • The New eHealth Exchange......................................................................4-7 – What is the eHealth Exchange?…………………………………………………………………………………………….. 4-5 – Origin and Oversight of NwHIN………………………………………………………………………………………………… 6 – NwHIN / Healtheway / eHealth Exchange Context…………………………………………………………………… 7 • Origin and Oversight of NwHIN…………………………………………………………… 8-20 – National Health Information Infrastructure (NHII)……………………………………………………………………. 8 – The NwHIN to Exchange from Prototype to Production…………………………………………………………… 9 – Definition of the eHealth Exchange……………………………………..……………………………….................... 10 – Office of the National Coordinator (ONC)……………………………………………….……………………………… 11 – Major ONC Initiatives…………………………………………………………………………………………………………….. 12 – Federal Health Architecture (FHA)…………………………………………………………………………………….. 13-14 – What is CONNECT?....................................................................................................................... 15 – NwHIN Overview: 2004 to Present……………………………………………………………………………………. 16-19 – For More Information…………………………………………………………………………………………………………….. 20 2 Table of Contents • eHealth Exchange: From Concept to Reality…………………….……………….. 21-41 – Exchange Operability Specifications Factory…………………………………………………………………………… 22 – Components of the eHealth Exchange……………………………..…………………………………………………23-24 – eHealth Exchange Specifications Overview……………………………………………………………….…............ 25 – Benefits of the Exchange………………………………………………………………………………………………………… 26 – eHealth Exchange Transition Overview (prior & current state)……………………………………………….. 27 – Content Harmonization Workgroup (C32 & C-CDA)………………………………………………………………… 28 – Healtheway Bundles (Service Specifications)………………………………………………………………………….. 29 – Collaboration with EHR/HIE Interoperability Workgroup (IWG)………………………………………… 30-31 – Onboarding eHealth Exchange………………………………………………………………………………………….. 32-41 • CONNECT………………………………………………………………………………………….. 42-50 – What is CONNECT?……………………………………………………………………………………………………………. 43-44 – Components of CONNECT…………………………………………………………………………………………………. 45-48 – Agencies that Collaborated to Create CONNECT…………………………………………………………………….. 49 – CONNECT Adopters………………………………………………………………………………………………………………… 50 • Bibliography……………………………………………………………………………………... 51-52 3 What is the eHealth Exchange? (formerly referred to as the Nationwide Health Information Network (NwHIN)) The eHealth Exchange transitioned from an ONC nationwide health information network program initiative, the NwHIN Exchange, to operate as a public-private A community of exchange partnership in October 2012. partners who share information Healtheway is a non-profit, public-private under a common trust partnership that operationally supports the eHealth Exchange. With production agreement, using a common set starting in 2009, the eHealth Exchange of technical requirements, has become a rapidly growing community policies and testing process. of public and private organizations, representing thousands of providers and millions of patients. Sources: http://www.healthewayinc.org 4 What is the eHealth Exchange? Activities: The eHealth Exchange helps to improve the health and welfare of all Americans through health information exchange that is trusted, scalable and enhances quality of care and health outcomes by supporting comprehensive longitudinal health records. Source: http://www.healthit.gov/providers-professionals/faqs/what-ehealth-exchange 5 Origin and Oversight of NwHIN NwHIN transitioned to the eHealth Exchange in October 2012 eHealth Exchange 6 NwHIN / eHealth Exchange / Healtheway Context Nationwide Health eHealth Exchange Healtheway Information Network A portfolio of standards, A community of exchange Non-profit organization services and policies partners who share information chartered to support the under a common trust eHealth Exchange and for secure exchange of agreement, using a common set focused on cross-industry health information of technical requirements, collaboration to advance over the Internet policies and testing process HIE implementation Operational governance Corporate board of directors established by contract to oversee Healtheway Federal program (Data Use and Reciprocal strategy and sustainability, initiative led by ONC Support Agreement – DURSA) no authority or oversight with oversight by of eHealth Exchange Coordinating Committee Sources: http://www.himssvirtual.org/VB/20121115_VB_IHE.asp Presentation: Healtheway IHE, November 15, 2012, M. Yeager 7 National Health Information Infrastructure (NHII) Evolution The eHealth Exchange has evolved since 2004 when it began as the National Health Information Infrastructure (NHII). NHII NHIN NwHIN Healtheway 2004 2010 2011 2012 Definition: The National Health Information Infrastructure (NHII) was a healthcare standardization initiative for the development of an interoperable health information technology system. NHII Goal: Build an interoperable system of clinical, public health and health information technology. How To Achieve NHII Goal: Encourage public-private partnership with a federal leadership role. Sources: (1) http://healthit.hhs.gov/portal/server.pt?open=512&objID=1407&parentname=CommunityPage&parentid=8&mode=2&in_hi_userid=11113&cached=true (2) Presentation NHII Tuturial, Dr. Yasnoff. July 20, 2004. http://156.98.150.11/e-health/npyasnoff.pdf 8 The NwHIN to Exchange from Prototype to Production NHIN Prototype Phase I: NHIN Prototype Phase II: • Contract awarded May 2007 • Contract awarded October 2007 for $22.5 M • Determination of need • “Specification Factory” • Four contractors involved: • Nine HIEs to participate in NHIN ‐ Accenture implementation: ‐ CSC ‐ CareSpark – (TN/VA) ‐ IBM ‐ Delaware Health Information Network ‐ Northrup Grumman ‐ Indiana University – Indianapolis ‐ Long Beach Network for Health (CA) • Demonstration model (i.e., prototype) only ‐ Lovelace Clinic Foundation (NM) ‐ MedVirginia (Central VA) ‐ New York eHealth Collaborative ‐ North Carolina Healthcare Information and Communications Alliance, Inc. ‐ West Virginia Health Information Network Source: (1) http://www.hhs.gov/news/press/2007pres/10/20071005a.html; (2) http://healthit.hhs.gov/portal/server.pt?open=512&objID=1407&parentname=CommunityPage&parentid=8&mode=2&in_hi_userid=11113&cached=true Both links Accessed 12/7/12. 9 Definition of the eHealth Exchange Definition: A set of standards, services and policies that enable secure health information exchange over the Internet. Goal: Operationalize the exchange of healthcare information nationwide utilizing the governance established by Contract (Data Use and Reciprocal Support Agreement – DURSA) with oversight by Coordinating Committee. Approach: Public-private venture. Stakeholders: • Care Delivery Organizations (CDOs) using EHRs • Consumer organizations operating Personal Health Records (PHRs) • Health Information Exchanges (HIEs) with multi-stakeholder entities to facilitate data within a state, region or group of stakeholders • Specialized participants (data for secondary uses) Source: http://www.healthewayinc.org/index.php/exchange/dursa 10 Office of the National Coordinator (ONC) Oversight of NwHIN through the Office of the National Coordinator (ONC) – 2004-2012 (Organizational Structure Detail – NwHIN governance transitioned to Healtheway, Inc., 10/2012) Source: Organizational Chart updated January 13, 2011; http://www.hhs.gov/about/orgchart/onc.html Accessed on 12/1/12. 11 Major ONC Initiatives The CONNECT program, while formally associated with Federal Health Architecture (FHA), has applicability to the eHealth Exchange. Source: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__onc_initiatives/1497 12 Federal Health Architecture (FHA) What is the FHA? • An e-Government line of business initiatives • Coordinates health IT activities among more than 20 federal agencies that provide health and healthcare services to citizens Goals: • Work with federal partners to build a federal health information technology environment • Interoperability with private sector systems • Support President’s plan to enable better point-of-service care, increase efficiency and improve overall health in the U.S. population Managed By: Office of the National Coordinator for Health IT Responsibilities: • Support federal efforts to deploy health IT standards • Ensure federal agencies seamlessly exchange health data among themselves; with state, local and tribal governments; and with the private sector Source: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__federal_health_architecture/1181 13 Federal Health Architecture (FHA) List of Participating Federal Agencies: 14 What is CONNECT? An open source software solution that supports health information exchange both locally and at the national level Initial Goal: Support the health-related missions of federal agencies Current Goal: Provide open-source software solutions to all organizations to assist health information exchanges and share data using nationally recognized interoperability standards Managing Partner: Department of Health & Human Services Lead Partners: Department of Health & Human Services, Department of Defense and Department of Veterans Affairs Other Partners (Alphabetical Order): Administration for Children and Families, Administration on Aging, Agency for Healthcare Research and Quality, Agency for Toxic Substances